Janice M Penn

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

54647-030 Issued in WI

Practice address

1615 Maple LN Ste 1
Essentia Health Ashland Clinic
Ashland, WI 54806-3610

Phone

(715) 685-7500

Fax

(715) 682-2481

NPI assigned

Jul 14, 2006

Last updated

May 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Duluth Clinic, LTD

  dba Essentia Health Ashland Clinic

  • Multi-Specialty Clinic/Center
  • Ashland, WI
  • NPI 1215974357
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1962428029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN STE 1",
            "address_2": "ESSENTIA HEALTH ASHLAND CLINIC",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063610",
            "telephone_number": "715-685-7500",
            "fax_number": "715-682-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN STE 1",
            "address_2": "ESSENTIA HEALTH ASHLAND CLINIC",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063610",
            "telephone_number": "715-685-7500",
            "fax_number": "715-682-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "JANICE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "54647-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131218900",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43935500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald G Patton, M.D.
• Nancy J Paulson, P.T.
• Sherri Paulson, LCSW
• Robin Pavelka, MS
• Heather Pawlak, FNP-BC
• Cheryl A Peterson, RN
• Michael Andrew Peterson
• Kammi L Phillips
• Hannah Powers, PT, DPT
• Sandra J. Principe, SAC, PS

• Adult Health Nurse Practitioner in Ashland, WI
• Providers in Ashland, WI by specialty
• Adult Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.